Tag Archives: risk adjustment
Minnesota struck a deal with five health plans in the state’s individual market to prevent a market collapse. In June, BCBS announced that it was leaving the individual market with 103,000 individuals left to find a new plan November 1st. It was feared that other plans would quickly follow suit.
October 18, 2016
Without a doubt, the next administration and Congress will face difficult decisions about how best to address the challenges facing the individual health insurance market. The Robert Wood Johnson Foundation is sponsoring a competition for teams of actuaries to develop solutions to improve that...
October 11, 2016
On August 12, federal judge Rebecca Ebinger entered the first decision in one of the growing number of cases challenging the administration of the premium stabilization programs, denying a motion for a preliminary injunction. CMS also announced a new hardship exemption to the individual mandate.
August 15, 2016
One day, ACA Marketplace plans may cover many of the 11 percent of Americans who remain uninsured. But the three programs---reinsurance, risk corridors, and risk adjustment---that the ACA’s drafters hoped would help stabilize premiums in the revamped markets have not performed as expected.
August 1, 2016
Foundations and others can partner with policy makers and researchers to play a critical role in addressing the remaining challenges for ACOs and in supporting the evolution of promising ACO models.
January 5, 2016
Implementing Health Reform: New CMS Guidance And First-Year Results (Northern Arapaho Tribe v. Burwell Update)
CMS recently announced the results from the SHOP exchange, reinsurance, and risk adjustment programs. Judge Scott Skavdahl of the United States District Court for the District of Wyoming also dismissed a lawsuit brought by the Northern Arapaho Tribe in which the Tribe claimed that it was exempt...
July 1, 2015